Page 1 of 45
PN HESI EXIT EXAM —HEALTH EDUCATION SYSTEMS
INCORPORATED (HESI) — ELSEVIER 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
PN HESI
Prepare for the PN HESI Exit Exam – Health Education Systems Incorporated (HESI)
Elsevier with a comprehensive study resource designed to reinforce core practical
nursing knowledge and clinical judgment. It supports review across major nursing
areas, including medical-surgical care, pharmacology, maternity, pediatrics, mental
health, gerontology, leadership, and fundamental nursing concepts. Use the material
to strengthen prioritization, improve test-taking confidence, and identify areas that
may require additional review for HESI and NCLEX-PN readiness. This resource is best
suited for practical nursing students preparing for the HESI PN Exit Exam and the
NCLEX-PN licensure examination.
MULTIPLE CHOICE.
SECTION 1: FUNDAMENTALS OF NURSING (20 Questions)
1. The PN is preparing to ambulate a postoperative client after cardiac
surgery. Which action is most important to ensure client safety?
• A) Apply a gait belt securely around the client's waist
• B) Instruct the client to hold the nurse's arm for support
• C) Walk on the client's surgical side
• D) Have the client take deep breaths before standing
Answer: A) Apply a gait belt securely around the client's waist
Rationale: A gait belt provides the nurse with a secure hold on the client
and prevents falls during ambulation. Clients after cardiac surgery are at
increased risk for falls due to medications, weakness, and orthostatic
hypotension. The gait belt is the most important safety measure.
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2. A client is receiving a blood transfusion and develops chills, fever, and
back pain. What is the priority nursing action?
• A) Slow the transfusion rate
• B) Stop the transfusion and notify the provider
• C) Administer diphenhydramine
• D) Administer acetaminophen
Answer: B) Stop the transfusion and notify the provider
Rationale: Symptoms of chills, fever, and back pain indicate a possible
hemolytic transfusion reaction, which is a medical emergency. The
transfusion should be stopped immediately, and the provider should be
notified. The blood bag and tubing should be saved for analysis.
3. A client with a urinary catheter has cloudy, foul-smelling urine. What
should the nurse do FIRST?
• A) Irrigate the catheter
• B) Notify the healthcare provider
• C) Obtain a urine specimen for culture
• D) Change the catheter
Answer: C) Obtain a urine specimen for culture
Rationale: Cloudy, foul-smelling urine indicates a possible urinary tract
infection. The nurse should obtain a urine specimen for culture and
sensitivity before starting antibiotics. The provider should be notified
after the specimen is obtained.
4. A client is receiving IV fluids. The nurse notes that the IV site is red,
swollen, and warm to the touch. What is the priority action?
• A) Apply a warm compress
• B) Discontinue the IV and restart at another site
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• C) Slow the infusion rate
• D) Notify the healthcare provider
Answer: B) Discontinue the IV and restart at another site
Rationale: Redness, swelling, and warmth at the IV site indicate phlebitis.
The IV should be discontinued immediately and restarted at another site.
The provider should be notified, but the priority is to remove the source of
irritation.
5. A client with a tracheostomy has thick secretions. Which intervention
should the nurse implement?
• A) Suction the tracheostomy every hour
• B) Increase the patient's fluid intake
• C) Apply a saline lock
• D) Change the tracheostomy tube
Answer: B) Increase the patient's fluid intake
Rationale: Increasing fluid intake helps thin secretions, making them
easier to suction. The nurse should also ensure adequate humidification
and perform suctioning as needed. Suctioning should not be performed
routinely, only when indicated.
6. A client is post-operative day 2 following abdominal surgery. The nurse
notes that the client has not had a bowel movement since before surgery.
Which action should the nurse take FIRST?
• A) Administer a prescribed stool softener
• B) Assess the client's abdomen for distension and bowel sounds
• C) Request an order for a laxative
• D) Encourage the client to ambulate
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Answer: B) Assess the client's abdomen for distension and bowel sounds
Rationale: The first step in the nursing process is assessment. Before
implementing any intervention, the nurse must assess the client's current
status. Postoperative ileus is a common concern, and assessment
findings will guide appropriate interventions.
7. A client is receiving enteral feedings via a nasogastric tube. Which
finding indicates the tube is properly placed?
• A) The client reports a sore throat
• B) The pH of aspirated fluid is 5.0
• C) The tube is suctioning gastric contents
• D) The client's abdomen is distended
Answer: C) The tube is suctioning gastric contents
Rationale: Suctioning gastric contents confirms the tube is in the
stomach. A pH of 5.0 is consistent with gastric placement (pH < 5.5). A
sore throat and distended abdomen are not indicators of proper
placement.
8. A client is being discharged with a new prescription for warfarin. Which
statement by the client indicates a need for further teaching?
• A) "I should wear a medical alert bracelet at all times."
• B) "I should avoid drinking alcohol while taking this medication."
• C) "I can take aspirin for headaches if I need to."
• D) "I should have my blood drawn regularly to check my INR."
Answer: C) "I can take aspirin for headaches if I need to."
Rationale: Aspirin should be avoided in patients taking warfarin because
it increases the risk of bleeding. Patients should consult their provider
before taking any new medications, including over-the-counter drugs.
PN HESI EXIT EXAM —HEALTH EDUCATION SYSTEMS
INCORPORATED (HESI) — ELSEVIER 2026/2027
COMPLETE (100) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
PN HESI
Prepare for the PN HESI Exit Exam – Health Education Systems Incorporated (HESI)
Elsevier with a comprehensive study resource designed to reinforce core practical
nursing knowledge and clinical judgment. It supports review across major nursing
areas, including medical-surgical care, pharmacology, maternity, pediatrics, mental
health, gerontology, leadership, and fundamental nursing concepts. Use the material
to strengthen prioritization, improve test-taking confidence, and identify areas that
may require additional review for HESI and NCLEX-PN readiness. This resource is best
suited for practical nursing students preparing for the HESI PN Exit Exam and the
NCLEX-PN licensure examination.
MULTIPLE CHOICE.
SECTION 1: FUNDAMENTALS OF NURSING (20 Questions)
1. The PN is preparing to ambulate a postoperative client after cardiac
surgery. Which action is most important to ensure client safety?
• A) Apply a gait belt securely around the client's waist
• B) Instruct the client to hold the nurse's arm for support
• C) Walk on the client's surgical side
• D) Have the client take deep breaths before standing
Answer: A) Apply a gait belt securely around the client's waist
Rationale: A gait belt provides the nurse with a secure hold on the client
and prevents falls during ambulation. Clients after cardiac surgery are at
increased risk for falls due to medications, weakness, and orthostatic
hypotension. The gait belt is the most important safety measure.
, Page 2 of 45
2. A client is receiving a blood transfusion and develops chills, fever, and
back pain. What is the priority nursing action?
• A) Slow the transfusion rate
• B) Stop the transfusion and notify the provider
• C) Administer diphenhydramine
• D) Administer acetaminophen
Answer: B) Stop the transfusion and notify the provider
Rationale: Symptoms of chills, fever, and back pain indicate a possible
hemolytic transfusion reaction, which is a medical emergency. The
transfusion should be stopped immediately, and the provider should be
notified. The blood bag and tubing should be saved for analysis.
3. A client with a urinary catheter has cloudy, foul-smelling urine. What
should the nurse do FIRST?
• A) Irrigate the catheter
• B) Notify the healthcare provider
• C) Obtain a urine specimen for culture
• D) Change the catheter
Answer: C) Obtain a urine specimen for culture
Rationale: Cloudy, foul-smelling urine indicates a possible urinary tract
infection. The nurse should obtain a urine specimen for culture and
sensitivity before starting antibiotics. The provider should be notified
after the specimen is obtained.
4. A client is receiving IV fluids. The nurse notes that the IV site is red,
swollen, and warm to the touch. What is the priority action?
• A) Apply a warm compress
• B) Discontinue the IV and restart at another site
, Page 3 of 45
• C) Slow the infusion rate
• D) Notify the healthcare provider
Answer: B) Discontinue the IV and restart at another site
Rationale: Redness, swelling, and warmth at the IV site indicate phlebitis.
The IV should be discontinued immediately and restarted at another site.
The provider should be notified, but the priority is to remove the source of
irritation.
5. A client with a tracheostomy has thick secretions. Which intervention
should the nurse implement?
• A) Suction the tracheostomy every hour
• B) Increase the patient's fluid intake
• C) Apply a saline lock
• D) Change the tracheostomy tube
Answer: B) Increase the patient's fluid intake
Rationale: Increasing fluid intake helps thin secretions, making them
easier to suction. The nurse should also ensure adequate humidification
and perform suctioning as needed. Suctioning should not be performed
routinely, only when indicated.
6. A client is post-operative day 2 following abdominal surgery. The nurse
notes that the client has not had a bowel movement since before surgery.
Which action should the nurse take FIRST?
• A) Administer a prescribed stool softener
• B) Assess the client's abdomen for distension and bowel sounds
• C) Request an order for a laxative
• D) Encourage the client to ambulate
, Page 4 of 45
Answer: B) Assess the client's abdomen for distension and bowel sounds
Rationale: The first step in the nursing process is assessment. Before
implementing any intervention, the nurse must assess the client's current
status. Postoperative ileus is a common concern, and assessment
findings will guide appropriate interventions.
7. A client is receiving enteral feedings via a nasogastric tube. Which
finding indicates the tube is properly placed?
• A) The client reports a sore throat
• B) The pH of aspirated fluid is 5.0
• C) The tube is suctioning gastric contents
• D) The client's abdomen is distended
Answer: C) The tube is suctioning gastric contents
Rationale: Suctioning gastric contents confirms the tube is in the
stomach. A pH of 5.0 is consistent with gastric placement (pH < 5.5). A
sore throat and distended abdomen are not indicators of proper
placement.
8. A client is being discharged with a new prescription for warfarin. Which
statement by the client indicates a need for further teaching?
• A) "I should wear a medical alert bracelet at all times."
• B) "I should avoid drinking alcohol while taking this medication."
• C) "I can take aspirin for headaches if I need to."
• D) "I should have my blood drawn regularly to check my INR."
Answer: C) "I can take aspirin for headaches if I need to."
Rationale: Aspirin should be avoided in patients taking warfarin because
it increases the risk of bleeding. Patients should consult their provider
before taking any new medications, including over-the-counter drugs.
